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Peds: Growth and Development > Growth and Development > Flashcards

Growth and Development Flashcards

1
Q

When does a child double their birth weight? triple?

A

Child typically doubles birth weight by 6 months & triples birth weight by 1 yr

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2
Q

When is 2/3 of brain size achieved?

A

2.5-3 yrs

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3
Q

What is the role of the PA in assessing a child?

A

During this period of growth & development, clinicians must assess child’s growth & development to:
A. Identify potential developmental concerns
B. Make appropriate interventions

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4
Q

What areas are evaluated during well child visits?

A 
1. Growth
A. Height, weight, head circumference
2. Nutrition, elimination patterns, sleep
3. Language
4. Gross & fine motor skills
5. Personal & social behaviors
6. Safety
7. Anticipatory Guidance
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5
Q

How is assessment of older children different than younger?

A

Higher cognitive function

Sexual maturation

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6
Q

What is the goal of wcc?

A
  1. Goal of the well child exam is to promote physical, emotional, mental & social well being
  2. Allows for prevention & treatment of illnesses & injuries
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7
Q

What are the weight trends for a newborn?

A
  1. Loses about 5 - 10% of his or her birth weight

2. By ≈ 2 weeks, infant should start to gain weight & grow quickly

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8
Q

What are the wt trends for 4-6 months?

A

Weight should double the birth weight

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9
Q

What are the wt trends for 12 months?

A

Weight should triple birth weight

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10
Q

What are the wt trends for 1-2 years?

A

Between ages 1 & 2 yr, a toddler will gain only ≈ 5 lb

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11
Q

What are the wt trends for 2-5 years?

A

Weight gain will remain at about 5 lb/yr between

2 – 5 yr

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12
Q

What are the normal growth rates of children?

A
  1. Between ages 5 - 10 years, a child will continue to grow at a steady pace
  2. A final growth spurt begins at the start of puberty, sometime between 9 & 15 yr
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13
Q

When do wcc occur?

A 
1-2 weeks
2 months
4 months
6 months
9 months
12 months
15 months
18 months
2 years 
3 years
4 years
5 years
Annually thru 21 years
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14
Q

What is included in the wcc hx?

A 
1. Growth Pattern
A. Length, weight, HC, BMI 
B. Flattening of curve is abnormal
2. Developmental  Milestones 
3. Nutrition
4. Elimination Pattern
5. Sleep Pattern
6. Social Interaction
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15
Q

What are nutritional requirements influenced by?

A
  1. Growth rate
    A. Higher in infancy
  2. Body composition
    A. In adults, brain contributes to 19% total basal energy expenditure
    B. In full term neonate, brain accts for 44% total basal energy expenditure
  3. Composition of new growth
    A. Infants have high rate fat deposition
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16
Q

What is the link between diet and development?

A
  1. Intellectual Development & Diet
    A. Poor nutrition can cause serious problems w/ intellectual development in children
    B. Poor diet -> fatigue -> impairs learning
    C. Poor nutrition -> illness -> missed school
  2. Breakfast particularly important
    A. Children may feel tired & unmotivated if skips
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17
Q

How can you counsel kids on nutritional requirements?

A 
1. Stress healthy eating habits at young age
A. Prevent obesity, DM, CV disease
2. Lifestyle counseling
A. Maintain desirable BMI
B. Regular physical activity
C. Limit sedentary behaviors
D. Avoid smoking
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18
Q

When can stuttering begin?

A
  1. Stuttering may occur in the normal language development of toddlers 3 - 4 years
    A. Ideas come to mind faster than child is able to express them, especially if toddler is stressed or excited
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19
Q

When should a kid be referred to a Speech pathologist?

A
  1. Refer to speech pathologist IF:
    A. There are other signs w/stuttering, such as tics, grimacing, or extreme self-consciousness
    B. Stuttering lasts > 6 months
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20
Q

What is the gradual increase pattern in social skills in infants?

A
  1. Recognize face/voice
  2. Smile
  3. Respond to name
  4. Stranger anxiety
  5. Demonstrate affection
  6. Increased social interaction throughout infant-toddler years
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21
Q

What are the social skills for preschoolers?

A
  1. Preschooler learns social skills necessary to play & work w/other children
    A. As time passes, child better able to cooperate w/↑ # of peers
  2. Preschoolers:
    A. Dominant child usually emerges who tends to boss around others
  3. Preschoolers test their limits (physical abilities, behaviors, expressions of emotion, & thinking)
    A. Need well-defined limits
22
Q

When do kids start participating in games with rules?

A

4 to 5-year-olds may be able to start participating in games that have rules

23
Q

What is a major cause of injury for preschoolers?

A
  1. Falls
  2. Toddlers & preschoolers are highly mobile & able to quickly get into dangerous situations
    A. Parental supervision at this age is essential
    B. Car safety is critical
    ALWAYS in a seatbelt & appropriate car seat
24
Q

Where is the major source of burns in preschoolers?

A

Kitchens and wood-stoves

25
Q

What anticipatory guidance that should be given for wcc?

A
  1. Sleep position
  2. Nutrition
  3. Fever in infants
  4. Dental care
  5. Family meals
  6. Literacy
  7. Water safety
  8. Sunscreen
  9. Bike/scooter/roller blade safety
  10. Seat belt/car seat
  11. Cigarette smoking
  12. Drug & alcohol use
  13. Sexual activity
26
Q

What are the PE components of a WCC?

A
  1. Length (>2 yr Ht)
  2. Weight
  3. HC
  4. BMI
    A. > 2 yr
  5. Vision
  6. Hearing
  7. BP
  8. Heart rate, resp rate
    9.General Appearance
  9. Skin
  10. HEENT
    Neck
27
Q

When does HC measurement end?

A

24 months

28
Q

When does BMI measurement begin?

A

Greater than 2 years

29
Q

When does vision screening begin?

A

A. Begin screening @ 3 yr

30
Q

When does hearing screening begin?

A

A. Annual sreening w/ audiometry beginning @ 4 yr

B. If suspect hearing problems prior, refer to Audiologist

31
Q

When do BP measurements begin?

A

3 yrs & older

32
Q

What is included in the HEENT component of PE?

A

Fontanelles, red reflex, corneal light reflex, visual tracking, ENT, dentition

33
Q

What are the PE components of a WCC?

A
  1. Length (>2 yr Ht)
  2. Weight
  3. HC
  4. BMI
    A. > 2 yr
  5. Vision
  6. Hearing
  7. BP
  8. Heart rate, resp rate
    9.General Appearance
  9. Skin
  10. HEENT
  11. Neck
  12. Cardiac
  13. Respiratory
  14. Abd
  15. Genitalia
  16. Femoral pulses
  17. Hips
  18. Extremities / MSK
  19. Neuro
34
Q

What is included in the abd exam of the child?

A

Auscultation, palpation, percussion

35
Q

What is included in neuro exams of children?

A

Muscle tone, hand grasp, DTR’s, developmental milestones

36
Q

When is lead screening recommended?

A

@ 1 yr & pre-school

37
Q

When is IDA screening recommended?

A

@ 12 months

38
Q

When is cholesterol screening recommended?

A

@ 9-11 yrs, then @ 17-21 yrs

39
Q

What are the 5 periods of normal growth?

A 
1. Newborn
A. First 28 days of life
2. Infancy
A. 1 month – 1 yr
3. Toddler
A. 13 months – 2 yr
4. Preschool years
A. 3- 5 yr
5. Middle childhood years
A. 6 – 9 yr
6. Adolescence
A. 10 – 19 yr
40
Q

When is cbc taken?

A

at 1 yr

41
Q

What are the potential problems for the newborn?

A
  1. Skin mottling, hemangiomas, nevi, Mongolian spots, birthmarks
  2. Jaundice
  3. Anterior or posterior fontanelle, shape, moulding, caput succedaneum, cephalohematoma
  4. Red reflex, subconjunctival hemorrhages
  5. Abdominal masses
  6. Genitalia
  7. Cardiac murmurs, femoral pulses
  8. Clavicle deformities, hip dysplasia, foot abnormalities
42
Q

What are the potential problems for the infant?

A
  1. Cardiac murmurs
  2. Hip dysplasia
  3. Abdominal masses
  4. Thrush
  5. Cradle cap
  6. Diaper rashes
  7. Tooth eruption in older infants (> 6 months)
43
Q

What are the potential problems for the toddlers and preschoolers?

A
  1. Early childhood caries
    A. Baby bottle tooth decay
  2. Excessive bruising or injuries
  3. Gait
44
Q

What are the potential problems for middle childhood?

A
  1. Caries, dental anomalies, malocclusions
  2. Early puberty
  3. Scoliosis
    A. Start screening at age 10
45
Q

What are the potential problems for adolescence?

A 
1. Tanner stages 
A. Older adolescence -> teach self breast & testicular self exams
2. Scoliosis
3. Evidence of eating disorders
4. Sports injuries
5. Dental problems
6. Acne
7. Tattoos, piercing
46
Q

What contributes to the exact age a child enters puberty?

A

Genetics, Nutrition, Gender

47
Q

What happens with hormones during puberty?

A
  1. During puberty, hormone production -> body changes & the development of secondary sex characteristics:
    A. Ovaries begin to increase production of estrogen & progesterone → menarche
    B. Testicles increase in size
    C. ↑ Axillary sweating, body odor, axillary & pubic hair
48
Q

How long does puberty last for females?

A 
1. Normal sequence of changes occur over 2 yrs:
A. Breast development – 1st sign
B. ↑ Height 
C. ↑ Hip size 
D. Clear or whitish vaginal secretions 
E. Pubic, axillary & leg hair growth
49
Q

True/false: menstrual irregularities are normal near menarche

A

True: Irregularity initially common

50
Q

When is puberty usually complete for females?

A

Full physical maturity reached by 17 yr, but educational & emotional maturity continue

51
Q

What is the sequence of changes in males during puberty?

A
  1. Enlargement of testicles – 1st sign
  2. Faster growth, especially height
  3. Hair growth in axilla, on face, & pubic area
  4. ↑ Shoulder width
  5. Growth of the penis
  6. Nighttime ejaculations
  7. Voice changes

Peds: Growth and Development (13 decks)

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